Healthcare Provider Details

I. General information

NPI: 1790018869
Provider Name (Legal Business Name): WEI L CHEN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2009
Last Update Date: 02/06/2020
Certification Date: 02/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 HURFFVILLE CROSS KEYS RD
TURNERSVILLE NJ
08012-2453
US

IV. Provider business mailing address

435 HURFFVILLE CROSS KEYS RD
TURNERSVILLE NJ
08012-2453
US

V. Phone/Fax

Practice location:
  • Phone: 856-218-5634
  • Fax: 856-218-5664
Mailing address:
  • Phone: 856-513-4124
  • Fax: 856-302-5932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number25MB09082300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: